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view-id-bmj_rapid_responses view-display-id-bmj_rr_article view-dom-id-771c9471b8dd1fba669f65bb6bb81874\u0022\u003E\n \u003Cdiv class=\u0022view-header\u0022\u003E\n \u003Cdiv id=\u0022response-header-description\u0022\u003ERapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. \u003Cem\u003EThe BMJ\u003C\/em\u003E reserves the right to remove responses which are being wilfully misrepresented as published articles.\u003C\/div\u003E \u003C\/div\u003E\n \n \u003Cdiv class=\u0022view-filters\u0022\u003E\n \u003Cform action=\u0022\/\u0022 method=\u0022get\u0022 id=\u0022views-exposed-form-bmj-rapid-responses-bmj-rr-article\u0022 accept-charset=\u0022UTF-8\u0022\u003E\u003Cdiv\u003E\u003Cdiv class=\u0022views-exposed-form\u0022\u003E\n \u003Cdiv class=\u0022views-exposed-widgets clearfix\u0022\u003E\n \u003Cdiv class=\u0022views-exposed-widget views-widget-sort-by\u0022\u003E\n \u003Cdiv class=\u0022form-type-select form-item-sort-by form-item form-group\u0022\u003E\n \u003Clabel for=\u0022edit-sort-by\u0022\u003ESort by \u003C\/label\u003E\n \u003Cselect class=\u0022form-control form-select\u0022 id=\u0022edit-sort-by\u0022 name=\u0022sort_by\u0022\u003E\u003Coption value=\u0022field_highwire_a_epubdate_value\u0022 selected=\u0022selected\u0022\u003EDate Published\u003C\/option\u003E\u003C\/select\u003E\n\u003C\/div\u003E\n \u003C\/div\u003E\n \u003Cdiv class=\u0022views-exposed-widget views-widget-sort-order\u0022\u003E\n \u003Cdiv class=\u0022form-type-select form-item-sort-order form-item form-group\u0022\u003E\n \u003Clabel for=\u0022edit-sort-order\u0022\u003EOrder \u003C\/label\u003E\n \u003Cselect class=\u0022form-control form-select\u0022 id=\u0022edit-sort-order\u0022 name=\u0022sort_order\u0022\u003E\u003Coption value=\u0022ASC\u0022\u003EAscending\u003C\/option\u003E\u003Coption value=\u0022DESC\u0022 selected=\u0022selected\u0022\u003EDescending\u003C\/option\u003E\u003C\/select\u003E\n\u003C\/div\u003E\n \u003C\/div\u003E\n \u003Cdiv class=\u0022views-exposed-widget views-widget-per-page\u0022\u003E\n \u003Cdiv class=\u0022form-type-select form-item-items-per-page form-item form-group\u0022\u003E\n \u003Clabel for=\u0022edit-items-per-page\u0022\u003EItems per page \u003C\/label\u003E\n \u003Cselect class=\u0022form-control form-select\u0022 id=\u0022edit-items-per-page\u0022 name=\u0022items_per_page\u0022\u003E\u003Coption value=\u00225\u0022\u003E5\u003C\/option\u003E\u003Coption value=\u002210\u0022 selected=\u0022selected\u0022\u003E10\u003C\/option\u003E\u003Coption value=\u002220\u0022\u003E20\u003C\/option\u003E\u003Coption value=\u002240\u0022\u003E40\u003C\/option\u003E\u003Coption value=\u002260\u0022\u003E60\u003C\/option\u003E\u003C\/select\u003E\n\u003C\/div\u003E\n \u003C\/div\u003E\n \u003Cdiv class=\u0022views-exposed-widget views-submit-button\u0022\u003E\n \u003Cinput class=\u0022btn btn-info form-submit\u0022 type=\u0022submit\u0022 id=\u0022edit-submit-bmj-rapid-responses\u0022 name=\u0022\u0022 value=\u0022Apply\u0022 \/\u003E \u003C\/div\u003E\n \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003C\/form\u003E \u003C\/div\u003E\n \n \n \u003Cdiv class=\u0022view-content\u0022\u003E\n \u003Cdiv class=\u0022views-row views-row-1 views-row-odd views-row-first\u0022\u003E\n \r\n\u003Cdiv class=\u0022node node-highwire-comment node-promoted clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022row rr-header\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022rr-left-column\u0022 class=\u0022\u0022\u003E\r\n\r\n \r\n \u003Cdiv class=\u0022response-title\u0022\u003E\r\n \u003Ca href=\u0022\/content\/368\/bmj.m998\/rr-1\u0022\u003E\u003Ch3\u003EMind the gap; rapid implementation should also include a system to report and learn from errors.\u003C\/h3\u003E\r\n \u003C\/a\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \r\n \r\n \u003Cdiv class=\u0022content\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022response-body\u0022\u003E\r\n \u003Cp\u003EDear Editor,\u003C\/p\u003E\n\u003Cp\u003EWe read with great interest the editorial by Greenhalgh et al. (BMJ 2020;368:m998) regarding the potential use of video consultation as a new model of care in response to the ongoing covid-19 pandemic. Of the two questions the authors pose, we would like to comment on the second: specifically, focusing on one of the challenges of scaling up this model at speed. \u003C\/p\u003E\n\u003Cp\u003EPrior to covid-19, we (Danish Society for Patient Safety) have been particularly interested in the role of telemedicine (of which video consultation is an example) in Danish healthcare. This is because, Denmark has been promoted as one of the world\u2019s most digitalized countries (1) and for the last 15 years the government has worked on joint public sector digital strategies,(2) one of which is the deployment of digital health solutions such as telemedicine, to \u2018provide freedom and empower individuals\u2019.(3) From this perspective, telemedicine is understood as \u2018the delivery of health care services using electronic communications and information technologies when participants are at different locations\u2019.(4)\u003C\/p\u003E\n\u003Cp\u003EEven before the current covid-19 pandemic, telemedicine was seen as a popular solution to meet some of demographic and economic challenges of 21st century healthcare provision; therefore, implementation continued at pace. As a result of the current need to reduce the spread of covid-19, there is obviously increasing interest and demand for the adoption of telemedicine across the healthcare system to support the safe provision of healthcare. As such, it seems appropriate for an organisation such as ours, which is devoted to patient safety and quality improvement, to ask a simple question: What learning has occurred from reviewing the data relating to the use of telemedicine \u2013 in particular, patient safety incidents. \u003C\/p\u003E\n\u003Cp\u003EIn 2019, we made an initial field analysis to answer this question. This process revealed data indicating a variety of risks and challenges for patients, professionals and the related authorities. This subsequently inspired us to map telemedicine patient safety related incidents in Denmark. Whilst we acknowledge, that the reporting of patient safety incidents does not necessarily provide the whole picture of the risk and harm associated with telemedicine, we believe it can contribute to learning about clinical sociotechnical interactions to develop safer systems and improve workflows.\u003C\/p\u003E\n\u003Cp\u003ELike a number of other countries, Denmark has a national incident reporting and learning system - Danish Patient Safety Database (DPSD) which enables patient safety incidents to be reported by healthcare providers. A recent modification to the system means patients and their families can now also report incidents.(5) A \u2018patient safety incident\u2019 is an event or circumstance that could have resulted, or did result, in unnecessary harm to a patient.(6) Once an event is reported to DPSD, it is automatically analysed locally for learning. At national level, the Danish Patient Safety Authority collects aggregated anonymized data from DPSD for learning and quality improvement. Each year, areas of interest are identified for deeper analysis at a national level. During 2018 almost 200,000 reports of patient safety incidents were administered. These range from \u2018non-significant medicotechnical errors\u2019 to \u2018serious harm to a patient\u2019. For each incident, the DPSD contains data fields such as \u2018date of incident\u2019, \u2018location\u2019, \u2018category\u2019 \u2018type of incident\u2019 e.g. medication error, and a free-text description of the incident. \u003C\/p\u003E\n\u003Cp\u003EUnfortunately, our attempt to collect data regarding telemedicine related patient safety incidents revealed only that the current configuration of DPSD does not provide a standardized way to report, collect, nor analyze data regarding telemedicine. There is simply no category for incidents when the health care is delivered digitally.\u003C\/p\u003E\n\u003Cp\u003EWe subsequently tried to collect data from the Danish Medicines Agency (DMA) regarding events including medical devices used in telemedicine. By law, any medical device malfunction, failure or deficiency should be notified to the DMA by healthcare professionals and manufacturers. All reports are subsequently reviewed to determine if the manufacturer should make changes to the device, update the instructions for use or if the device should be removed from the market.(7) The current reporting system at DMA has similar limitations to DPSD. As such, it was not possible to extract patient safety incident data regarding medical devices used in telemedicine.\u003C\/p\u003E\n\u003Cp\u003EThis can only lead us to believe that there is currently a gap between the current implementation of telemedicine, and the related modifications to the reporting systems developed to support potential for learning and quality improvement.\u003Cbr \/\u003E\nInformation relevant to all stakeholders is falling through that gap. As a consequence, patients may be exposed to unnecessary harm, health care workers may inflict and be held responsible for unnecessary harm, and the authorities are unable to recognise potential trends in harm across the system.\u003C\/p\u003E\n\u003Cp\u003EThe actions necessary to close this gap, and therefore reduce these potential harms, needn\u2019t be overwhelming; new categories and reporting processes need to be adapted within the current system. The recent change to the system to allow patients and families to report incidents is an example of how modifications can be made. \u003C\/p\u003E\n\u003Cp\u003EAs noted in the editorial: \u201c\u2026given the many clinical, technical, organisational, and policy questions raised by this promising service model and the natural experiment we are probably about to witness (due to covid-19), we strongly recommend a research call to ensure that we maximise the lessons learnt\u201d.\u003C\/p\u003E\n\u003Cp\u003EOur recommendation is supplementary to this. Alongside the testing and implementation of any new technology, there needs to be an equivalent system of identifying, recording and learning from incidents involving that new technology. However, this is not where we find ourselves with telemedicine. If Denmark, or any other country, wants to succeed in the rapid utilization of telemedicine to support care provision during the current pandemic, or indeed as an international leader in digitalization, it will also need to be a world leader in systems to support reporting and learning. \u003C\/p\u003E\n\u003Cp\u003E1 European Commission website\u003Cbr \/\u003E\nThe Digital Economy and Society Index (DESI)\u003Cbr \/\u003E\n\u003Ca href=\u0022https:\/\/ec.europa.eu\/digital-single-market\/en\/desi\u0022\u003Ehttps:\/\/ec.europa.eu\/digital-single-market\/en\/desi\u003C\/a\u003E\u003Cbr \/\u003E\nDate accessed: January 30, 2020\u003C\/p\u003E\n\u003Cp\u003E2 Danish Agency for Digitisation\u003Cbr \/\u003E\nDigital Strategy 2016-2020\u003Cbr \/\u003E\n\u003Ca href=\u0022https:\/\/en.digst.dk\/policy-and-strategy\/digital-strategy\/\u0022\u003Ehttps:\/\/en.digst.dk\/policy-and-strategy\/digital-strategy\/\u003C\/a\u003E\u003Cbr \/\u003E\nDate accessed: January 30, 2020\u003C\/p\u003E\n\u003Cp\u003E3 Danish Agency for Digitisation\u003Cbr \/\u003E\nNational dissemination of telemedicine for patients with COPD by the end of 2019\u003Cbr \/\u003E\n\u003Ca href=\u0022https:\/\/en.digst.dk\/policy-and-strategy\/digital-welfare\/telemedicine\/\u0022\u003Ehttps:\/\/en.digst.dk\/policy-and-strategy\/digital-welfare\/telemedicine\/\u003C\/a\u003E\u003Cbr \/\u003E\nDate accessed: January 30, 2020\u003C\/p\u003E\n\u003Cp\u003E4 Danish National Health Data Authority\u003Cbr \/\u003E\nHealthcare conceptual framework\u003Cbr \/\u003E\n\u003Ca href=\u0022https:\/\/sundhedsdatastyrelsen.dk\/nbs\u0022\u003Ehttps:\/\/sundhedsdatastyrelsen.dk\/nbs\u003C\/a\u003E\u003Cbr \/\u003E\nDate accessed: January 30, 2020\u003C\/p\u003E\n\u003Cp\u003E5 Danish Patient Safety Authority\u003Cbr \/\u003E\nPatient safety incidents\u003Cbr \/\u003E\n\u003Ca href=\u0022https:\/\/stps.dk\/da\/laering\/utilsigtede-haendelser\/\u0022\u003Ehttps:\/\/stps.dk\/da\/laering\/utilsigtede-haendelser\/\u003C\/a\u003E\u003Cbr \/\u003E\nDate accessed: January 30, 2020\u003C\/p\u003E\n\u003Cp\u003E6 WHO\u003Cbr \/\u003E\nPatient Safety\u003Cbr \/\u003E\n\u003Ca href=\u0022https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/patient-safety\u0022\u003Ehttps:\/\/www.who.int\/news-room\/fact-sheets\/detail\/patient-safety\u003C\/a\u003E\u003Cbr \/\u003E\nDate accessed: January 30, 2020\u003C\/p\u003E\n\u003Cp\u003E7 Danish Medicines Agency\u003Cbr \/\u003E\nReporting of incidents and accidents with medical devices\u003Cbr \/\u003E\n\u003Ca href=\u0022https:\/\/laegemiddelstyrelsen.dk\/en\/devices\/incident-reporting\/\u0022\u003Ehttps:\/\/laegemiddelstyrelsen.dk\/en\/devices\/incident-reporting\/\u003C\/a\u003E\u003Cbr \/\u003E\nDate accessed: January 30, 2020\u003C\/p\u003E\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-competing\u0022\u003E\r\n \u003Cp\u003E\u003Cstrong\u003ECompeting interests: \u003C\/strong\u003E\r\n No competing interests\u003C\/p\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \u003C\/div\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-right-column\u0022 class=\u0022\u0022\u003E\r\n \u003Cdiv class=\u0022response-date\u0022\u003E\r\n \u003Cstrong\u003E27 March 2020\u003C\/strong\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-author\u0022\u003E\r\n Simon A Tulloch \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-occupation\u0022\u003E\r\n Psychologist \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-other_authors\u0022\u003E\r\n Dr Tatjana Sandreva \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-affiliation\u0022\u003E\r\n Danish Society of Patient Safety \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-address\u0022\u003E\r\n Dansk Selskab for Patientsikkerhed, c\/o Frederiksberg Hospital, Nordre Fasanvej 57, K\u00f8benhavn, Danmark \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022twitter-address\u0022\u003E\r\n \u003Ca href=\u0022https:\/\/twitter.com\/@simontulloch\u0022\u003E@simontulloch\u003C\/a\u003E \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-links\u0022\u003E\r\n\r\n \r\n \r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-separator\u0022 class=\u0022clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022light-grey-line\u0022\u003E\u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n\u003C\/div\u003E\r\n \u003C\/div\u003E\n \u003Cdiv class=\u0022views-row views-row-2 views-row-even\u0022\u003E\n \r\n\u003Cdiv class=\u0022node node-highwire-comment node-promoted clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022row rr-header\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022rr-left-column\u0022 class=\u0022\u0022\u003E\r\n\r\n \r\n \u003Cdiv class=\u0022response-title\u0022\u003E\r\n \u003Ca href=\u0022\/content\/368\/bmj.m998\/rr-0\u0022\u003E\u003Ch3\u003ERe: Video consultations for covid-19 - as a Triage mechanism and need for triggering health system response in Pandemics\u003C\/h3\u003E\r\n \u003C\/a\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \r\n \r\n \u003Cdiv class=\u0022content\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022response-body\u0022\u003E\r\n \u003Cp\u003EDear Editor,\u003C\/p\u003E\n\u003Cp\u003EThe authors have highlighted the potential use of video consultations for COVID-19 and outlined some of the system level challenges for implementation and scale up. \u003C\/p\u003E\n\u003Cp\u003EDespite the limited evidence, video consultations are widely used in resource-limited settings with robust telecommunication networks and a large number citizens use smart phones.\u003C\/p\u003E\n\u003Cp\u003EFor example in India, there are several health start-ups offering video consultations, primarily as a triage tool providing medical advice and guidance on referral for further management. Majority of these video consultations and the referrals are external to the public health delivery systems. In India, nearly 70% of the healthcare delivery is by the private sector(1). The testing for COVID-19 is currently only available at designated government laboratories. In a fragmented health delivery ecosystem, video consultations could be the first line of contact between a suspected case with COVID-19 and the health-systems. The video consultation platforms could be mandated to trigger notifications on potential cases that need further evaluation and confirmatory testing for COVID-19. This would help strengthen the national disease surveillance network. \u003C\/p\u003E\n\u003Cp\u003EMoreover, as healthcare delivery establishments are likely to be overwhelmed with a large number of seriously ill COVID-19 patients in the forthcoming days, the video consultation platforms would serve a complimentary role in serving as an extension of the health delivery establishments. In addition, embedding machine learning algorithms into the video consultation platform could facilitate automation of the triage particularly for responding queries and help triage those at risk from those not at risk based on a symptom checklist and interactive voice interface that utilizes natural language processing capabilities (2). A potential model of remote home monitoring incorporating video consultations and remote virtual presence for chronic conditions such as end stage kidney disease have been described(3). COVID-19 offers an unprecedented opportunity to augment the health systems capacity leveraging these digital health tools.\u003C\/p\u003E\n\u003Cp\u003EReferences:\u003Cbr \/\u003E\n1.\tNational Family Health Survey (NFHS-4), 2015-16: India.\u003Cbr \/\u003E\n2.\tKuziemsky C, Maeder AJ, John O, Gogia SB, Basu A, Meher S, Ito M. Role of artificial intelligence within the telehealth domain. Yearbook of medical informatics. 2019 Aug;28(01):035-40.\u003Cbr \/\u003E\n3.\tJohn O, Jha V. Remote Patient Management in Peritoneal Dialysis: An Answer to an Unmet Clinical Need. InRemote Patient Management in Peritoneal Dialysis 2019 (Vol. 197, pp. 99-112). Karger Publishers.\u003C\/p\u003E\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-competing\u0022\u003E\r\n \u003Cp\u003E\u003Cstrong\u003ECompeting interests: \u003C\/strong\u003E\r\n The Author is Secretary of Asia Pacific Association for Medical Informatics and leads strategic engagement for the Digital Health India Association - a non profit agency that engages with Ministries of Health for progressing the digital health agenda towards SDGs.\u003C\/p\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \u003C\/div\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-right-column\u0022 class=\u0022\u0022\u003E\r\n \u003Cdiv class=\u0022response-date\u0022\u003E\r\n \u003Cstrong\u003E13 March 2020\u003C\/strong\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-author\u0022\u003E\r\n Oommen John \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-occupation\u0022\u003E\r\n Clinician, Public Health Research, Health Innovations \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-other_authors\u0022\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-affiliation\u0022\u003E\r\n The George Institute for Global Health India \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-address\u0022\u003E\r\n The George Institute for Global Health India, New Delhi \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022twitter-address\u0022\u003E\r\n \u003Ca href=\u0022https:\/\/twitter.com\/@oommen_john\u0022\u003E@oommen_john\u003C\/a\u003E \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-links\u0022\u003E\r\n\r\n \r\n \r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-separator\u0022 class=\u0022clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022light-grey-line\u0022\u003E\u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n\u003C\/div\u003E\r\n \u003C\/div\u003E\n \u003Cdiv class=\u0022views-row views-row-3 views-row-odd views-row-last\u0022\u003E\n \r\n\u003Cdiv class=\u0022node node-highwire-comment node-promoted clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022row rr-header\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022rr-left-column\u0022 class=\u0022\u0022\u003E\r\n\r\n \r\n \u003Cdiv class=\u0022response-title\u0022\u003E\r\n \u003Ca href=\u0022\/content\/368\/bmj.m998\/rr\u0022\u003E\u003Ch3\u003ERemote consultations yes, but why video?\u003C\/h3\u003E\r\n \u003C\/a\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \r\n \r\n \u003Cdiv class=\u0022content\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022response-body\u0022\u003E\r\n \u003Cp\u003EDear Editor\u003C\/p\u003E\n\u003Cp\u003EWhile Greenhalgh et al are right that the current Covid-19 crisis is prompting GPs to look at ways to avoid face-to-face contact they are wrong to focus on the use of Video consultations. There is a big danger in promoting cool technology when simpler alternatives are more effective.\u003C\/p\u003E\n\u003Cp\u003EMany GPs are already using online services for remote consultations in their routine practice (COI, I provide analytics to askmyGP, alternative platforms are available). Whatever previous published studies (most of which are weak and underpowered) say about patients being satisfied with video, there is a large volume of evidence that suggests they rarely choose it when offered better alternatives.\u003C\/p\u003E\n\u003Cp\u003EFor example, askmyGP has processed around 1.7 million requests to GP practices since late 2018. This service allows patients to send a secure message to their GP describing their problem which the GP can read immediately and respond to in a variety of ways (patients can also contact their practice by phone to make the request; only about 30% do). The patient is asked their preferred method for the GP response (a phone call, a secure message, a face-to-face appointment or a video call). The GP can triage the request and choose a response (including asking for further information). The GP can choose to use a different response medium than the one requested by the patient (many f-to-f requests are handled by messages and many messages result in a f-to-f appointment). The mix of requested and delivered methods should be of interest.\u003C\/p\u003E\n\u003Cp\u003EIn the 8 weeks from 20 January 2020 to 12 March 2020 askmyGP processed around 390 thousand patient requests. Of these only about 118k requested a f-to-f appointment, 110k a message and 143k a phone call (some patients who telephone their practice are not asked how they want the practice to respond). Only 357 (not thousand, just three hundred and fifty seven in total) requested video. Also worth noting is the fact that about 12k requests and responses involved sending a photo attachment (that\u0027s more than 30 times more than those requesting a video).\u003C\/p\u003E\n\u003Cp\u003EPatient satisfaction with askmyGP is very high (all requests are offered to chance to provide feedback and about 3% do and about 70% of responses give a top FFT response). \u003C\/p\u003E\n\u003Cp\u003EOur conclusion is that when patients and GPs are offered a variety of effective ways to communicate or have a remote consultation including video, very few choose video. Given the variety of practice types and the number of patients covered, this is a very significant result compared to the small trials reported in the literature, many of which did not test whether video consultations were better than other online or telephone alternatives. \u003C\/p\u003E\n\u003Cp\u003EWe do not think that this evidence supports the promotion of video as the primary \u0022best response\u0022 to encouraging remote consultations as a response to Covid-19.\u003C\/p\u003E\n\u003Cp\u003EPS we are very happy to share the raw data behind this conclusion with anyone who wants to validate it or investigate it further and have already done so with the analytics team at a major health think tank.\u003C\/p\u003E\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-competing\u0022\u003E\r\n \u003Cp\u003E\u003Cstrong\u003ECompeting interests: \u003C\/strong\u003E\r\n I provide the analytics for online GP service askmyGP (company name GP Access)\u003C\/p\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \u003C\/div\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-right-column\u0022 class=\u0022\u0022\u003E\r\n \u003Cdiv class=\u0022response-date\u0022\u003E\r\n \u003Cstrong\u003E12 March 2020\u003C\/strong\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-author\u0022\u003E\r\n stephen black \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-occupation\u0022\u003E\r\n data scientist \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-other_authors\u0022\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-affiliation\u0022\u003E\r\n black box data science and GP Access \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-address\u0022\u003E\r\n biggleswade, bedfordshire \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022twitter-address\u0022\u003E\r\n \u003Ca href=\u0022https:\/\/twitter.com\/@sib313\u0022\u003E@sib313\u003C\/a\u003E \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-links\u0022\u003E\r\n\r\n \r\n \r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-separator\u0022 class=\u0022clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022light-grey-line\u0022\u003E\u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n\u003C\/div\u003E\r\n \u003C\/div\u003E\n \u003C\/div\u003E\n \n \n \n \n \n \n\u003C\/div\u003E \u003C\/div\u003E\n\n \n \u003C\/div\u003E\n\u003C\/div\u003E\n \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003C\/body\u003E\u003C\/html\u003E"}